Hyponatremia as A Prognostic Indicator for Hepatic Encephalopathy in Cirrhotic Patients

Abd El-Ghany, Hesham Atia; Gawish, Heba Hassan; Al Mukhtar, Abd Alrouf Ammar; Shaker, Shady E

doi:10.21608/zumj.2023.236401.2892

	Hyponatremia as A Prognostic Indicator for Hepatic Encephalopathy in Cirrhotic Patients
Zagazig University Medical Journal
Article 23, Volume 30, Issue 4, July and August 2024, Page 1226-1243 PDF (1.02 MB)
Document Type: Original Article
DOI: 10.21608/zumj.2023.236401.2892
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Authors
Hesham Atia Abd El-Ghany¹; Heba Hassan Gawish²; Abd Alrouf Ammar Al Mukhtar ¹; Shady E Shaker ¹
¹Internal Medicine Department, Faculty of Medicine, Zagazig University
²Clinical Pathology Department, Faculty of Medicine, Zagazig University
Abstract
Background: ‏Hepatic encephalopathy is a frequent and serious complication of both chronic liver disease and acute liver failure that lead to impaired quality of life, increased morbidity and mortality. Hyponatremia, a cause of brain dysfunction and risk factor for hepatic encephalopathy, is frequent in patients with advanced cirrhosis and ascites. The interdependence of liver failure and hyponatremia makes it difﬁcult to separate the effects of each on cognitive function. Aim: To study the correlation between serum sodium levels and serum ammonia levels in relation with hepatic encephalopathy in patients with liver cirrhosis and to evaluate the association between hyponatremia and hyperammonia with mortality. Patients and methods: This case control prospective cohort study was conducted at Internal Medicine Department, Zagazig University Hospitals. Subjects were divided into group (A) (control group): apparent healthy age and sex matched participants, group (B) (case group): cirrhotic patients who were subdivided into: group (B1) cirrhotic patients with class A child pugh, group (B2): cirrhotic patients with class B child pugh and group (B3): cirrhotic patients with class C child pugh. Routine laboratory investigations and sodium were measured. Results: On multiple regression analysis, AFP, MELD score, ammonia, ALT, hyperammonia and hyponatremia were significant predictors of mortality in cirrhotic patients. Conclusion: Hyponatremia and hyperammonemia is a prognostic indicator for hepatic encephalopathy in Cirrhotic Patients and can be used as a predictor to mortality.
Keywords
Hyponatremia; Hepatic Encephalopathy; Cirrhotic


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